Epidemiology and Comorbidity of Vitiligo in Germany: A Claims Data Analysis

Vitiligo is a chronic skin disease resulting in destruction of melanocytes and loss of pigmentation. Little is known about epidemiology and comorbidity in Germany. This retrospective cohort analysis used nationwide statutory health insurance data (2016 to 2020). Disease rates were calculated using varying case definitions. Comorbidity was assessed against 3 control groups: persons without vitiligo, with atopic dermatitis, and with psoriasis (1:3 propensity score matching). In 2020, 4,631 persons were diagnosed with vitiligo in DAK-Gesundheit (DAK-G, mean age 56.93 years, ~148,437) and 5,820 persons in the German Analysis Database for Evaluation and Health Services Research (~144,855). Prevalence ranged from 0.12% (confidence interval [CI] 0.12-0.12) to 0.20% (CI 0.19-0.20), and incidence from 0.04% (CI 0.03-0.04) to 0.06% (CI 0.06-0.06). Rates increased with age. Women (mean age 58.60 years) were more frequently affected. Vitiligo was associated with alopecia areata (relative risk 7.14, CI 4.63-11.00) and systemic sclerosis (relative risk 3.20, CI 1.58-6.47). Several mental illnesses (depression: relative risk = 1.23, CI 1.15-1.32, anxiety: relative risk = 1.32, CI 1.19-1.47), were linked to skin diseases like vitiligo, atopic dermatitis, or psoriasis. Vitiligo affects a notable proportion of the population, with detected comorbidities supporting prior findings. To ensure reliable results, claims data should be validated through primary data linkage or sensitivity testing.